The candidate, Said A. Ibrahim, MD, MPH, is Associate Professor of Medicine in the Division of General Internal Medicine and core faculty in the Center for Research on Health Care at the University of Pittsburgh. He is also core faculty in the VA national Center for Health Equity Research and Promotion in Pittsburgh, PA. This application details how the K24 Mid-Career Investigator Award in Patient-Oriented Research will enable the candidate to advance his innovative and progressive research program focused on addressing the racial/ethnic disparities in the utilization of knee/hip joint replacement in patients with knee/hip osteoarthritis (OA). It will also ensure that the candidate has adequate protected time to devote to mentoring the next generation of medical students, residents, clinical and post-doctoral fellows and junior faculty trainees, particularly those from under-represented minorities, in patient-oriented health disparities research. The research and career goals of the candidate and this proposal are consistent with the US Department of Health and Human Services' national initiative to reduce or eliminate racial and ethnic disparities in health and health care by 2010 and the NIH mandate from Congress to address health care disparities. [unreadable] [unreadable] The candidate's research will be conducted in 2 phases. In Phase I (Years 1-3), he will direct 2 investigator initiated studies on understanding and intervening on racial disparity in joint replacement utilization for knee/hip OA. In Phase II (Years 4-5), he will expand his research to examine the efficacy of joint replacement disparity interventions in a nationally representative sample with adequate representation of women and minorities. Health care research trainees and junior faculty mentored by the candidate will be integral participants in his research activities throughout the award period. Over the course of the award, the candidate will mentor approximately 5 medical students and residents, 6 clinical and/or post-doctoral fellows, and 5 junior faculty members in health disparities research. Research training and education experiences, tailored to the level of the mentee, will include mentored health disparities research projects, participation in a weekly journal club, regular research seminars, and formal training as appropriate. [unreadable] [unreadable] The proposed research and mentoring programs will be conducted at the University of Pittsburgh, which has a strong institutional commitment to the professional development of the candidate and a mission to support health care research throughout its many affiliated health sciences schools, departments, and centers. These schools provide a myriad of clinical research training programs, including NIH-funded fellowship programs in Medicine, a Clinical Research Training Program (K30), a Multidisciplinary Clinical Research Scholars Program (K12), and a Clinical and Translational Science Award Program. [unreadable] [unreadable] [unreadable] [unreadable]